Medical reviews often face ethics conflicts

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ethics conflict BOSTON (Reuters) - Scientists assigned to monitor the ethics of medical studies often help decide whether to approve research even when they have financial ties to the company sponsoring the work, a study shows.

Almost one-third of those polled said they "sometimes" or "always" voted on research projects where they had a relationship with the sponsor or the experiment was sponsored by a company competing with one they were financially linked with.

Under federal regulations, researchers who review medical experiments are supposed to avoid conflicts of interest so that patients who volunteer in studies are not subject to reckless research in which scientists might make a profit.

The study was published in this week's New England Journal of Medicine and surveyed 563 members of institutional review boards.

The survey also found that most scientists who sit on the boards had received no guidance about what constituted a conflict of interest or what to do if they faced a conflict.

Nearly one in three board members from 100 medical schools and research hospitals did not respond to the survey. Among those who did respond, just over one in three had ties to industry and 15 percent reported they had faced a potential conflict of interest at least once during the past year.

That's not a problem if they avoid projects where there is a possible conflict of interest.

But many did not.

Nearly one-third said they participated in the discussion at least some of the time when they had a conflict and one-half said they usually did not leave the room when such projects were discussed. Only about one-third of the respondents said they usually did not get involved in the discussion when they had a potential conflict.

Discussing and voting on such proposals suggests "possible violations of federal regulations," the research team, led by Eric Campbell of the Massachusetts General Hospital, found.

Federal regulations require that members not participate in the review of a project where they have a conflict of interest except to provide information specifically requested by the review board.

"Our policies and procedures, as well as our efforts to educate IRB (institutional review board) members about conflicts of interest, are clearly inadequate," said Greg Koski, another member of the team.

Part of the problem is the lack of clearly articulated rules. "Half the members said their institution didn't have a written policy on conflict of interest, or didn't know if they had one," Campbell told Reuters.

He said preventing scientists with ties to industry from serving on review committees was not the answer, partly because those relationships have become so pervasive in the research community.

But there should be clear rules designed to make sure those relationships are disclosed and scientists are taught to exclude themselves from the process if they have a potential conflict of interest, he said.

"Banning relationships outright is not appropriate," he said. "We need to disclose them. We need to manage them."

© Reuters 2006